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Death raises questions: Did Prince die of an OD?

CHICAGO — Prince’s final days and unexpected death at age 57 raise questions among experts familiar with prescription painkiller overdoses. It’s possible the innovative musician’s demise represents one of the most public tragedies in an overdose crisis now gripping America.

Whether Prince was addicted to painkillers is uncertain, but some are wondering whether the stigma surrounding addiction may have prevented Prince — who built a reputation as a sober superstar — from seeking help if he was becoming dependent.

Does pain treatment lead to addiction?With good management and no history of addiction, opioids can help people find relief from pain with only a small risk of causing addiction, according to a 2010 systematic review of the available studies.“If you do not have a past history of addiction and are in your 40s and getting pain treatment with opioids, your odds of becoming newly addicted are low,” said Maia Szalavitz, author of “Unbroken Brain,” a newly published book about addiction. “One study of thousands of ER visits for overdose found that only 13 percent of victims had a chronic pain diagnosis.”If Prince had become addicted, Szalavitz said, he may have shunned seeking help.

What is naloxone?The overdose antidote naloxone has been saving lives for decades, reversing the effect of opiates since it was approved in 1971. Hospital emergency rooms and ambulance crews use an injectable generic version to revive people whose breathing has slowed or stopped during a drug overdose.Needle-exchange programs in many cities distribute take-home naloxone kits to active drug users. Many experts consider these giveaways of generic injectable naloxone to be a public health success story that has saved thousands of lives.One of the naloxone products, Narcan, was used after Prince’s plane made an emergency stop in Moline, Ill., April 15 and he was found unconscious on the plane, the law enforcement official told the AP. The official said the so-called “save shot” was given when the plane was on the runway in Moline as Prince returned to Minneapolis following a performance in Atlanta.Narcan is carried by Carver County sheriff’s department officers, Sheriff Jim Olson said at a news conference April 22.

How does naloxone work?Naloxone works by reversing the effects of opiates in the brain and at higher doses can immediately trigger withdrawal symptoms like nausea.Some drug users wake up cursing emergency personnel for ruining their high. Dr. Steven Aks, emergency medicine physician and medical toxicologist at Stroger Hospital in Chicago, has seen it happen.Aks has revived many patients with a naloxone shot. “Too many to count,” he said. It’s an almost daily occurrence in the Chicago ER.”

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